After developement of antimicrobial chemotherapy, morbidity and mortality from pyogenic arthritis has been reduced dramatically, but still this disease has remained as a serious and lifethreatening infectious disease of childhood or late sequelae in surviving patients. For the period of 7 years from January 1973 to December 1979, fifty nine children who were treated as septic arthritis at Severance Hospital were studied retrospectively and the results are summerized as follows. 1. Among the 59 cases, 32 cases (54.25%) were male and 27 cases (45.8%) were female. The most prevalent age was 4 to 10 years (40%). 2. Lag period to treatment in most cases was 5 days, and the most prevalent signs on admission was pain around the involved joint. 3. The most commonly affected joint was the hip joint (42.4%). The other affected sites in order of frequency were the knee, ankle and shoulder joint. 4. The underlying causes were composed of infectious focus in 18 cases, minor trauma in 6 cases, iatrogenic reason in 4 cases and unknown in 31 cases. 5. In laboratory findings, the numbers of W.B.C. and E.S.R. were increased in 66.1%, and roentgenologic studies revealed normal in 67.7%, soft tissue swelling in 21% and joint space widening in 9.7%. 6. Causative micro-organism was isolated in 41 cases: Staphylococcus aureus in 34 cases. B-hemolytic streptococcus in 3, Pseudomonas aeroginosa in 2, Enterobacter species in 2. 7. Staphylococcus aureus was highly sensitive to Cephalothin (88.2%) and Methycillin (85.3%), but was highly resistant to Penicillin (88.2%). 8, Four cases were treated non-surgically and 55 cases surgically with arthrotomy-drainage and arthrotomy-continuous irrigation. The results were satisfactory in 83% and unsatisfactory in 17%. 9. The complications were found in 14 cases: recurrence in 4, joint stiffness in 3, dislocation in 2 and sepsis in 1 case. In conclusion, a better result was obtained in cases with early diagnosis and surgical treatment with proper antibiotics.
Ankle ; Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Cephalothin ; Child ; Clinical Study ; Communicable Diseases ; Dislocations ; Drug Therapy ; Early Diagnosis ; Enterobacter ; Female ; Hip Joint ; Humans ; Joints ; Knee ; Male ; Mortality ; Penicillins ; Pseudomonas ; Recurrence ; Retrospective Studies ; Sepsis ; Shoulder Joint ; Staphylococcus aureus ; Streptococcus

No abstract available.
Cryptococcosis* ; Tuberculosis, Pulmonary*

No abstract available.
Metatarsal Bones* ; Osteogenesis, Distraction*

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

Congenital dislocation of the knee is very rare deformity and presents with anterior displacement of the tibia in relation to the femur. Early gentle manipulation and serial splintage or plaster cast is recommended for treatment and successful in the majority except the case of quadriceps contracture or late correction. We experienced two cases of bilateral congenital dislocation of the knee who had been treated with early gentle manipularion, immobilization with serial corrective dual splint, passive stretching and night splint. Our results are good in both cases.
Casts, Surgical ; Congenital Abnormalities ; Contracture ; Dislocations ; Femur ; Immobilization ; Knee ; Muscle Stretching Exercises ; Splints ; Tibia

24-hour Holter ambulatory ECG monitoring has been examined for the cardiac evaluation during ordinary activities in 81 subjects with suspected or propostmyocardial infarction (PMI), 12-lead ECG and the 24-hour ECG tape showed similar basic rhythm, heart rates and conduction patterns, but ventricular premature contractions (VPCs) were more frequently recorded on the 24-hour tape. Of 17 PMI patients, one or more VPCs in 14 cases (82.4%), multifocal VPCs in 3 cases (17.6%) and bigeminy or paired VPCs in 5 cases (29.4%) and transient runs of ventricular tachycardia in 1 case (5.9%) were observed on the 24-hour monitoring. 2) Of 30 patients with typical or atypical chest pain, 20 examinees had changes in the ST segment and/or T wave, but 10 examinees did not have any pathological changes in the ST segment or in the T wave. 3) Of 26 patients with dizziness and palpitation during waking periods, sinus rates were 76.4+/-12.8/min. and the ranges were 134.1+/-15.1/min. and 58.7+/-9.1/min. Average sinus rates observed during sleeping periods were 61.6+/-10.3/min., the ranges were 92.7+/-11.4/min. and 51.5+/-8.7/min. In general, longer PR interval, QTc interval, QRS duration and high R amplitude were observed during sleeping periods than waking periods. 4) Of 64 patients without PMI, all subjects had episodes of normal sinus rhythm and brady-and-tachycardia syndrome in 5 cases, VPCs in 23 cases, APCs in 2 cases, AV block in 4 cases and W.P.W. syndrome in 2 cases were observed during 24-hour Holter ECG monitoring.
Atrioventricular Block ; Chest Pain ; Dizziness ; Electrocardiography* ; Heart Rate ; Humans ; Infarction ; Tachycardia, Ventricular

No abstract available.
Polychondritis, Relapsing*

No abstract available.
Polychondritis, Relapsing*

No abstract available.
Fractures, Compression* ; Vertebroplasty*

BACKGROUND: This study was undertaken to evaluate the effect of plasma concentration of vitamin C is on the plasma total antioxidant status(TAS) in patients with paraquat intoxication. METHODS: As a preliminary research for this study, we measured plasma vitamin C levels, uric acid, TAS, and bilirubin from 100 healthy Koreans aged between 25-55 years. Various concentrations of vitamin C were constructed in vitro with normal pooled plasma between 1mg/dl and 100 mg/dL and TAS was measured. Both vitamin C concentrations and TAS were measured from the blood samples, taken at 0.5, 1, 2, 3, 5, 7, 9 hours after a bolus injection of vitamin C(50 mg/kg) from 7 volunteers who had been recruited from medical students at our hospital. Various amounts of vitamin C were given to 10 patients with paraquat intoxication for 5 consecutive days in the morning : first day ; 100 mg single dose, second day; 500 mg single dose, third day ; 1,000 mg single dose, fourth day : 3,000 mg single dose, and fifth day ; 3,000 mg three times every 8 hours. RESULTS: The mean value of TAS and vitamin C measured in 100 healthy Korean adults was 2.22 +/-0.16 mmol/L and 0.48+/-0.10 mg/dL. Age and sex do not influence these levels(p> 0.05, data are not presented). A direct correlation was observed between TAS and vitamin C concentrations of 1 mg/dL and 100 mg/dL both in vivo and vitro. As the vitamin C concentration was increased gradually 5 consecutive days, the TAS values increased in the same way as follows : first day(vitamin C 100 mg) 2.26+/-0.98 mmol/L, second day(vitamin C 500 mg) 2.76+/-0.78 mmol/L, third day(vitamin C 1.000 mg) 2.81+/-0.68 mmol/L, fourth day(vitamin C 3.000 mg) 3.18 mmol/L. On the fifth day when 3.000 mg of vitamin C was given by bolus intravenous injection 3 times(every 8 hours for a day), the TAS values measured one hour after the injection was 3.58+/-0.37 mmol/L. CONCLUSION: When vitamin C is used as a free radical scavenger, the loading dose and maintenance dose should be around 2278 mg intravenous bolus and 146 mg/hour. High doses of vitamin C are effective and safe for patients with acute paraquat intoxication.
Adult ; Ascorbic Acid* ; Bilirubin ; Free Radical Scavengers ; Humans ; Injections, Intravenous ; Paraquat* ; Plasma* ; Pulmonary Fibrosis ; Students, Medical ; Uric Acid ; Vitamins* ; Volunteers